Difference between revisions of "Pharmacy Inpatient Setup"

Revision as of 01:46, 23 October 2011

Inpatient Pharmacy took a good while to set-up. Here are my notes on how I have done that. I have only done Unit Dose though. Questions: Post on the hardhats Google Group. http://groups.google.com/group/hardhats.

Prerequisites for Set-up

• MAS Wards and Rooms have to be completely configured before you start configuring Inpatient Pharmacy, as Inpatient Pharmacy Parameters references them.
• Menu: PSJU MGR
• Key: PSJU MGR for access to the Supervisor Menu
• Menu: PSS MGR (No keys necessary except for entering drugs)

Printers Configuration

You can be of course a high tech place with Automatic Drawers (Pyxii or OmniCells), ATCs and BCMA. This section is for the rest of us who may need printed MARs, Pick Lists to fill the Carts, and Labels to send new medications to the Wards.

For general help setting up printers on Unix, go here: Setting up a Linux Printer. The authors (including me) don't cover how to add a printer to Unix using cups; you should find how to do that yourself. We cover how to add a Unix Printer to VISTA.

The following to help you configure the various printer types that Inpatient Pharmacy uses.

Pick Lists

Pick lists print on normal paper. Configure a printer with the following SubType: P-HPLJ4SI-P12

NAME: P-HPLJ4SI-P12                     SELECTABLE AT SIGN-ON: NO
  RIGHT MARGIN: 96                      FORM FEED: #
  PAGE LENGTH: 57                       BACK SPACE: $C(8)
  OPEN EXECUTE: W $C(27,69),$C(27),"&l0O",$C(27),"(0N",$C(27),"(s0p12h0s0b4099T"
,$C(27),"&k2G" S $X=0                   DESCRIPTION: HP JL4Si 12 pitch Courier

Labels

VISTA UD Package expects 15/16" high 3.5 wide labels 2 across in a dot-matrix label printer. It's hardcoded in the Mumps routines. So hardcoded that you can only change labels with difficulty. If you have Zebras, Medsphere has written code to do Zebras in OpenVista. As to what Printer SubType to use, that depends on the printer. I have an Epson FX-890 and it took me a couple of weeks of trial and error to get this SubType I made: P-EPSON-DM-P15-5L

NAME: P-EPSON-DM-P15-5L                 RIGHT MARGIN: 132
  FORM FEED: ""                         PAGE LENGTH: 5
  BACK SPACE: $C(8)
  OPEN EXECUTE: W *27,"@",*27,"g",*27,"2",*27,"C",*5,*27,"0",*27,"N",*1,*27,"k",
*1,*27,"2"
  DESCRIPTION: Epson Dot-Matrix 15 cpi/5 lpi
 OPEN EXECUTE DESCRIPTION:   
  *27,"@",         Reset 
  *27,"g",         15 cpi 
  *27,"2",         1/6 in line spacing 
  *27,"C",*5,      Page Length = 5 * 1/6 in = 5/6 in 
  *27,"0",         1/8 in line spacing 
  *27,"N",*1,      Bottom Margin = 1 * 1/8  = 1/8 in 
  *27,"k",*1,      Font = Sans Serif 
  *27,"2"          1/6 in line spacing 

To my disappointment, if you put anything in the close execute, it will be executed even if you do nothing in the Unit Dose package but browse a patient. This caused the labels to "jiggle". I had to remove close executes after all. The other funny thing I discovered is that the UD package does not send any form feeds to move to the next label: just an line feed. It's very unorthodox, making it difficult to write correct sequences, until I figured out that it 'guesses' the next label by doing a line feed and (after a lot of testing the disbelief from me) it works okay.

MARs

If you are not using BCMA for eMARs, you will need paper MARs. VISTA can print MARs for Paper Documentation, with Active Medications Pre-Printed. I tried printing them as Portrait; and for a while, I couldn't get to print them as Landscape until I wrote the exact correct PCL for me. My nurses prefer the Landscape version. Here are the subtypes you need for MARs:

Portrait:

NAME: P-HPLJ2-P16                       SELECTABLE AT SIGN-ON: NO
  RIGHT MARGIN: 132                     FORM FEED: #
  PAGE LENGTH: 80
  OPEN EXECUTE: W *27,"E",*27,"(8U",*27,"(s0P",*27,"(s16H",*27,"(s9V",*27,"(s0S"
,*27,"(s-3B",*27,"(s0T",*27,"&l88P",*27,"&a255M",*27,"&k2S",*27,"&l8D",*27,"&s1C
",*27,"&k2G"                            CLOSE EXECUTE: W *27,"E"

Landscape:

NAME: P-HPLJ2-P16-LS                    SELECTABLE AT SIGN-ON: NO
  RIGHT MARGIN: 132                     FORM FEED: #
  PAGE LENGTH: 80
  OPEN EXECUTE: W *27,"E",*27,"&l1O",*27,"(8U",*27,"(s0P",*27,"(s16H",*27,"(s9V"
,*27,"(s0S",*27,"(s-3B",*27,"(s0T",*27,"&l88P",*27,"&l0E",*27,"&l0L",*27,"&a18L"
,*27,"&k2S",*27,"&l8D",*27,"&s1C",*27,"&k2G"
  CLOSE EXECUTE: W *27,"E"

Pre-Exchange Report

I found most printer types work fine here. I just use the Pick List definition.

Schedule Set-up

Find the Hospital's policy for their Administration Times, prohibited abbreviations, and whether some wards get specific administration times. In my case, the Children's Ward had different administration times. You may delete Schedules are not used.

Menu: PSS MGR > Standard Schedule Edit

My end result:

<code>
ADMINISTRATION SCHEDULE List                          AUG 11,2011@14:41   PAGE 1

NUMBER: 51                              NAME: 5/D
  STANDARD ADMINISTRATION TIMES: 09-12-15-18-21
  FREQUENCY (IN MINUTES): 288           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: FIVE TIMES DAILY

NUMBER: 42                              NAME: AC
  STANDARD ADMINISTRATION TIMES: 07-11-16
  FREQUENCY (IN MINUTES): 480           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: BEFORE MEALS

NUMBER: 2                               NAME: BID
  STANDARD ADMINISTRATION TIMES: 09-21  FREQUENCY (IN MINUTES): 720
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: TWICE A DAY
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08-20

NUMBER: 46                              NAME: IMODIUM PRN
  FREQUENCY (IN MINUTES): 60            PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: PRN
  OUTPATIENT EXPANSION: INITIAL 2 CAP THEN 1 CAP AFTER LS - MAX 8

NUMBER: 36                              NAME: MO-WE-FR
  STANDARD ADMINISTRATION TIMES: 09     PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS

NUMBER: 47                              NAME: NITRATE
  FREQUENCY (IN MINUTES): 300           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS

NUMBER: 27                              NAME: NOW
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: ONE-TIME

NUMBER: 35                  	            NAME: ONCE
  STANDARD ADMINISTRATION TIMES: 1600   FREQUENCY (IN MINUTES): 1440
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: ONE-TIME
  MAX DAYS FOR ORDERS: 1

NUMBER: 43                              NAME: PC
  STANDARD ADMINISTRATION TIMES: 0830-1230-1830
  FREQUENCY (IN MINUTES): 480           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: AFTER MEALS

NUMBER: 11                              NAME: Q12H
  STANDARD ADMINISTRATION TIMES: 09-21  FREQUENCY (IN MINUTES): 720
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: EVERY 12 HOURS
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08-20

NUMBER: 38                              NAME: Q2H
  STANDARD ADMINISTRATION TIMES: 01-03-05-07-09-11-13-15-17-19-21-23
  FREQUENCY (IN MINUTES): 120           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: EVERY 2 HOURS

NUMBER: 53                              NAME: Q2WEEKS
  STANDARD ADMINISTRATION TIMES: 09     FREQUENCY (IN MINUTES): 20160
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: Once every 2 weeks
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08

NUMBER: 5                               NAME: Q3H
  STANDARD ADMINISTRATION TIMES: 01-04-07-10-13-16-19-22
  FREQUENCY (IN MINUTES): 180           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: EVERY 3 HOURS

NUMBER: 4                               NAME: Q4H
  STANDARD ADMINISTRATION TIMES: 01-05-09-13-17-21
  FREQUENCY (IN MINUTES): 240           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: EVERY 4 HOURS
WARD: Child 2R 214-225 South
  WARD ADMINISTRATION TIMES: 04-08-12-16-20-24

NUMBER: 50                              NAME: Q5MIN
  FREQUENCY (IN MINUTES): 5             PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: Every 5 Minutes

NUMBER: 3                               NAME: Q6H
  STANDARD ADMINISTRATION TIMES: 06-12-18-24
  FREQUENCY (IN MINUTES): 360           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: EVERY 6 HOURS

NUMBER: 6                               NAME: Q8H
  STANDARD ADMINISTRATION TIMES: 01-09-17
  FREQUENCY (IN MINUTES): 480           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: EVERY 8 HOURS
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08-16-24

NUMBER: 7                               NAME: QAM
  STANDARD ADMINISTRATION TIMES: 09     FREQUENCY (IN MINUTES): 1440
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: EVERY MORNING
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08

NUMBER: 1                               NAME: QDAY
  STANDARD ADMINISTRATION TIMES: 09     FREQUENCY (IN MINUTES): 1440
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: ONCE A DAY
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08

NUMBER: 23                              NAME: QHS
  STANDARD ADMINISTRATION TIMES: 21     FREQUENCY (IN MINUTES): 1440
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: AT BEDTIME
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 20

NUMBER: 10                              NAME: QID
  STANDARD ADMINISTRATION TIMES: 09-13-17-21
  FREQUENCY (IN MINUTES): 360           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: FOUR TIMES A DAY
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08-12-16-20

NUMBER: 12                              NAME: QOD
  STANDARD ADMINISTRATION TIMES: 09     FREQUENCY (IN MINUTES): 2880
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: EVERY OTHER DAY
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08

NUMBER: 54                              NAME: QPM
  STANDARD ADMINISTRATION TIMES: 05     FREQUENCY (IN MINUTES): 1440
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: Every Evening

NUMBER: 52                              NAME: QWEEKLY
  STANDARD ADMINISTRATION TIMES: 09     FREQUENCY (IN MINUTES): 10080
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: CONTINUOUS
  OUTPATIENT EXPANSION: Once a week
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08

NUMBER: 39                              NAME: STAT
  PACKAGE PREFIX: PSJ                   TYPE OF SCHEDULE: ONE-TIME

NUMBER: 9                               NAME: TID
  STANDARD ADMINISTRATION TIMES: 09-15-21
  FREQUENCY (IN MINUTES): 480           PACKAGE PREFIX: PSJ
  TYPE OF SCHEDULE: CONTINUOUS          OUTPATIENT EXPANSION: THREE TIMES A DAY
WARD: Child 2R 214-225 South            WARD ADMINISTRATION TIMES: 08-14-20

NUMBER: 41                              NAME: TODAY
  STANDARD ADMINISTRATION TIMES: 1230-1330
  FREQUENCY (IN MINUTES): 60            PACKAGE PREFIX: PSO
  MAX DAYS FOR ORDERS: 1

NUMBER: 40                              NAME: TOMORROW
  STANDARD ADMINISTRATION TIMES: 0815-0915-1015
  FREQUENCY (IN MINUTES): 60            PACKAGE PREFIX: PSO
  TYPE OF SCHEDULE: ONE-TIME            MAX DAYS FOR ORDERS: 1
</code>

Drug File Set-up

Entering Drugs

Before you do anything, you need to enter all the drugs that your pharmacy uses from your pharmacy formulary. That will take 1-3 months. Here's how: Enter a Drug. Before I started, I deleted all traces of the old drug file using this routine I wrote: http://bazaar.launchpad.net/~sam-habiel/astronaut-vista-server/enhancements/view/head:/JJIHDCLR.m

Also, I learned it may be better to configure the Schedules first before doing the drugs, as you use Schedules when you make orderable items. So I would recommend that. I didn't do that when I set-up the drug file, so I had to go back and fix some stuff after I was done.

IV Room Set-up

The next step is to set-up the IV Room. While technically not needed if you are only doing Unit Dose, it's required for some options in the UD menu to work.

Select Unit Dose Medications Option: IOE  Inpatient Order Entry

Whoops ... You don't have an IV ROOM defined ... 
You MUST define at least one IV ROOM before you can continue.

Select IV ROOM: NULL
  Are you adding 'NULL' as a new IV ROOM (the 1ST)? No//   (No) ??

Select IV ROOM: NULL ROOM
  Are you adding 'NULL ROOM' as a new IV ROOM (the 1ST)? No// Y  (Yes)
NAME: NULL ROOM// 
LENGTH OF LABEL: 5??
     Type a whole number between 12 and 66.
LENGTH OF LABEL: 12
WIDTH OF LABEL: ??
          Enter the maximum allowable width of your label in number of character
s.
        If you do not enter data into this field, the system will use '30' as
        the default.  If a line of print cannot fit within the width you define 
        here, it will continue on the next line of the label.
   
WIDTH OF LABEL: 35
LINE FEEDS BETWEEN LABELS: N??
     Type a whole number between 0 and 6.
LINE FEEDS BETWEEN LABELS: 1
END OF LABEL TEXT: **ICH SOUTH**
HEADER LABEL:   
SHOW BED LOCATION ON LABEL: 
USE SUSPENSE FUNCTIONS: 
DOSE DUE LINE: 
LVP'S GOOD FOR HOW MANY DAYS: 1
HYPERAL GOOD FOR HOW MANY DAYS: 1
PB'S GOOD FOR HOW MANY DAYS: 1
SYRN'S GOOD FOR HOW MANY DAYS: 1
CHEMO'S GOOD FOR HOW MANY DAYS: 1
STOP TIME FOR ORDER: 
EXPIRE ALL ORDERS ON SAME DAY: 
ACTIVITY RULER: 
TOTAL VOL. ON HYPERAL LABELS: 
Select START OF COVERAGE: ??
Select START OF COVERAGE: 0830
  Are you adding '0830' as a new START OF COVERAGE (the 1ST for this IV ROOM)? 
No// Y  (Yes)
  END OF COVERAGE: 1700
  TYPE: A  ADMIXTURES AND PRIMARIES
  MANUFACTURING TIME: 1200
  DESCRIPTION: 0830 to 1700// 
Select START OF COVERAGE: "0830"
  Are you adding '0830' as a new START OF COVERAGE (the 2ND for this IV ROOM)? 
No// Y  (Yes)
  END OF COVERAGE: 1700
  TYPE: P  PIGGYBACKS
  MANUFACTURING TIME: 1200
  DESCRIPTION: 0830 to 1700// 
Select START OF COVERAGE: "0830"
  Are you adding '0830' as a new START OF COVERAGE (the 3RD for this IV ROOM)? 
No// Y  (Yes)
  END OF COVERAGE: 1700
  TYPE: H  HYPERALS
  MANUFACTURING TIME: 1200
  DESCRIPTION: 0830 to 1700// 
Select START OF COVERAGE: "0830 ??
Select START OF COVERAGE: "0830"
  Are you adding '0830' as a new START OF COVERAGE (the 4TH for this IV ROOM)? 
No// Y  (Yes)
  END OF COVERAGE: 1700
  TYPE: S  SYRINGE
  MANUFACTURING TIME: 1200
  DESCRIPTION: 0830 to 1700// 
Select START OF COVERAGE: "0830"
  Are you adding '0830' as a new START OF COVERAGE (the 5TH for this IV ROOM)? 
No// Y  (Yes)
  END OF COVERAGE: 1700
  TYPE: C  CHEMOTHERAPY
  MANUFACTURING TIME: 1200
  DESCRIPTION: 0830 to 1700// 
Select START OF COVERAGE: ?
    Answer with START OF COVERAGE
   Choose from:
   1            0830  
   A covering from 0830 to 1700
   2            0830  
   P covering from 0830 to 1700
   3            0830  
   H covering from 0830 to 1700
   4            0830  
   S covering from 0830 to 1700
   5            0830  
   C covering from 0830 to 1700
         
        You may enter a new START OF COVERAGE, if you wish
        Answer must be in military time (i.e., 4 NUMBERS)!
   
Select START OF COVERAGE: 
Select DELIVERY TIME: 1500
  Are you adding '1500' as a new DELIVERY TIME (the 1ST for this IV ROOM)? No//
 Y  (Yes)
Select DELIVERY TIME: 
LABEL DEVICE: HOME//   TELNET

REPORT DEVICE: HOME//   TELNET

INACTIVATION DATE: 
DAYS TO RETAIN IV STATS: 

You are signed on under the NULL ROOM IV ROOM

Current IV LABEL device is: TELNET

Current IV REPORT device is: TELNET

System Parameters

Go to Supervisor Menu > PARameters Edit Menu > Systems Parameters Edit

Select PARameters Edit Menu Option: systems Parameters Edit

NON-FORMULARY MESSAGE:
  THERE ARE NO LINES!
  Edit? NO// y  YES

[ WRAP ]==[INSERT ]=========< NON-FORMULARY MESSAGE [Press <F1>H for help]====
This drug is non-formulary. Please contact the Inpatient Pharmacy before 
ordering.

PRINT 6 BLOCKS FOR THE PRN MAR: 1 YES ''Recommended''
PRINT DIET ABBR LABEL ON MAR:   ''Don't turn on unless you use Dietetics''
MAR SORT: ?
     Choose from: 
       0        Sort by order's Schedule Type and then Medication Names.
       1        Sort by order's Medication Names.
MAR SORT: 0  Sort by order's Schedule Type and then Medication Names.
ATC SORT PARAMETER: 
CALC UNITS NEEDED PRN ORDERS: ?
     Enter a 1 if you would like to have the UNITS NEEDED calculated for PRN
     orders on the Pick List.
     Choose from: 
       1        YES
CALC UNITS NEEDED PRN ORDERS: 
DAYS UNTIL STOP FOR ONE-TIME: 1
ROUND ATC PICK LIST UNITS: 
EXPIRED IV TIME LIMIT: ?
     Type the Number of Hours between 0 and 24 that continuous IV orders may be
     renewed after expiring
EXPIRED IV TIME LIMIT: 
PRIORITIES FOR PENDING NOTIFY: ?
     Choose from: 
       S        STAT
       SA       STAT/ASAP
       SAN      STAT/ASAP/NOW
       A        ASAP
       AN       ASAP/NOW
       N        NOW
       SN       STAT/NOW
PRIORITIES FOR PENDING NOTIFY: 
PRIORITIES FOR ACTIVE NOTIFY: 

Ward Parameters Set-up

To reach this menu, you need to go to Supervisor Menu > PARameters Edit Menu. What you do here is configure the parameters for how Inpatient Pharmacy will behave for the Ward (or as Americans like to call it nowadays: Unit). You need to collect the following information:

• When do Orders have to get renewed? That will you Days until stop.
• When should Orders stop when they expire? That's called the "Order Wall".
• When should the Start Date be? As soon as the med is ordered, or at the next admin time?
• Are you going to print labels when you process the orders? When?

Here's an example for one ward I configured. All my other wards look the same

Select Supervisor's Menu Option: PARameters Edit Menu

          AUto-Discontinue Set-Up
   IUP    Inpatient User Parameters Edit
   IWP    Inpatient Ward Parameters Edit
          Clinic Definition
          Systems Parameters Edit

Select PARameters Edit Menu Option: IWP  Inpatient Ward Parameters Edit

Select WARD: ?
      
     You may enter a new INPATIENT WARD PARAMETERS, if you wish
     Enter a ward for which you want to tailor the Inpatient Medication
     package.
 Answer with WARD LOCATION NAME
 Do you want the entire 15-Entry WARD LOCATION List? Y  (Yes)Choose from:
   1St Floor                               *** INACTIVE ***
   Adolescent 2L 201-213 South     
                                   to exit: 
   Child 2R 214-225 South     
   Dapa 3R 314-326     
   General/adult 3L 300-313 South          *** INACTIVE ***
   Hinniker 1R 118-129 South               *** INACTIVE ***
   Ichs Admissions                         *** INACTIVE ***
   Ichs Adolescent                         *** INACTIVE ***
   Ichs Adult                              *** INACTIVE ***
   Ichs Beds                               *** INACTIVE ***
   Ichs Child                              *** INACTIVE ***
   Ichs Dapa                               *** INACTIVE ***
   Ichs Hiniker                            *** INACTIVE ***
   Intracare Hospital System               *** INACTIVE ***
   Restore 1L 101-111 South     
   
Select WARD: RESTORE 1L 101-111 SOUTH    
  Are you adding 'Restore 1L 101-111 South' as 
    a new INPATIENT WARD PARAMETERS (the 1ST)? No// Y  (Yes)

DAYS UNTIL STOP DATE/TIME: 30
DAYS UNTIL STOP FOR ONE-TIME: 1
SAME STOP DATE ON ALL ORDERS: Y  YES
TIME OF DAY THAT ORDERS STOP: 2359
DEFAULT START DATE CALCULATION: ?
     Enter "0" to use the closest admin time, "1" to use the next admin time,
     or "2" to use "now" as the default start time for orders.
     Choose from: 
       0        USE CLOSEST ADMIN TIME AS DEFAULT
       1        USE NEXT ADMIN TIME AS DEFAULT
       2        USE NOW AS DEFAULT
DEFAULT START DATE CALCULATION: 1  USE NEXT ADMIN TIME AS DEFAULT
START TIME FOR 24 HOUR MAR: 1500
LABEL FOR WARD STAFF: ?
     Choose from: 
       0        NO LABELS
       1        FIRST LABEL ON ORDER ENTRY/EDIT
       2        LABEL ON ENTRY/EDIT AND VERIFICATION
       3        FIRST LABEL ON NURSE VERIFICATION
LABEL FOR WARD STAFF: 0  NO LABELS
WARD LABEL PRINTER POINTER: 
LABEL FOR PHARMACY: ?
     Choose from: 
       0        NO LABELS
       1        FIRST LABEL ON ORDER ENTRY/EDIT
       2        LABEL ON ENTRY/EDIT AND VERIFICATION
       3        FIRST LABEL ON PHARMACIST VERIFICATION
LABEL FOR PHARMACY: 3  FIRST LABEL ON PHARMACIST VERIFICATION
PHARMACY LABEL PRINTER POINTER: PHAR
     1   PHAR-IP-DM      Inpatient Pharmacy Dot-Matrix     PHAR-IP-DM     
     2   PHAR-IP-LS      IP Pharmacy Landscape     <pipe>     
CHOOSE 1-2: 1  PHAR-IP-DM    Inpatient Pharmacy Dot-Matrix     PHAR-IP-DM     
LABEL ON AUTO-DISCONTINUE: ?
     Answer 'YES' to have labels created when this ward's patients' orders are
     auto-discontinued.
     Choose from: 
       1        YES
       0        NO
LABEL ON AUTO-DISCONTINUE: 0  NO
MAR HEADER LABELS: ?
     Enter "YES" if MAR header labels should be generated for this ward.
     Choose from: 
       1        YES
MAR HEADER LABELS: 1   YES
DAYS NEW LABELS LAST: ?
     Enter a whole number between 0 and 35.

ANY NEW LABELS OLDER THAN THE NUMBER OF DAYS SPECIFIED HERE WILL
AUTOMATICALLY BE PURGED.
DAYS NEW LABELS LAST: ?
     Enter a whole number between 0 and 35.

ANY NEW LABELS OLDER THAN THE NUMBER OF DAYS SPECIFIED HERE WILL
AUTOMATICALLY BE PURGED.
DAYS NEW LABELS LAST: 1
MAR ORDER SELECTION DEFAULT: ?
     Answer must be 1-10 characters in length.


  Enter the number corresponding to the type of orders to be included on
MARs printed for this ward. Multiple types (except 1) may be selected
using "-" or "," as delimiters.

Choose from: 
             1 - All Medications
             2 - Non-IV Medications only
             3 - IV Piggybacks
             4 - LVPs
             5 - TPNs
             6 - Chemotherapy Medications (IV)
MAR ORDER SELECTION DEFAULT: 2
                                               2 - Non-IV Medications only
PRINT PENDING ORDERS ON MAR: ?
     Enter YES to include acknowledged pending orders on the MARs
     Choose from: 
       1        YES
PRINT PENDING ORDERS ON MAR: ??
        Enter YES to include the pending orders that were acknowledged by a nurs
e
        on the MARs and the Medication Due Worksheet.
   
     Choose from: 
       1        YES
PRINT PENDING ORDERS ON MAR: 
'SELF MED' IN ORDER ENTRY: 
PRE-EXCHANGE REPORT DEVICE: ?
     Enter a device on which the Pre-Exchange Report may be printed.
 Answer with DEVICE NAME, or LOCAL SYNONYM, or $I, or VOLUME SET(CPU), or
     SIGN-ON/SYSTEM DEVICE, or FORM CURRENTLY MOUNTED
 Do you want the entire DEVICE List? N  (No)
PRE-EXCHANGE REPORT DEVICE: PHAR-IP-LS      IP Pharmacy Landscape     <pipe>    
STAT NOW MAIL GROUP: ?
 Answer with MAIL GROUP NAME
 Do you want the entire 236-Entry MAIL GROUP List? N  (No)
STAT NOW MAIL GROUP: PSJ
     1   PSJ STAT NOW ACTIVE ORDER  
     2   PSJ STAT NOW PENDING ORDER  
     3   PSJ-ORDERS REINSTATED  
CHOOSE 1-3: 2  PSJ STAT NOW PENDING ORDER
PRIORITIES FOR NOTIFICATION: ?
     Choose from: 
       S        STAT
       SA       STAT/ASAP
       SAN      STAT/ASAP/NOW
       A        ASAP
       AN       ASAP/NOW
       N        NOW
       SN       STAT/NOW
PRIORITIES FOR NOTIFICATION: SAN  STAT/ASAP/NOW

Medication Distribution Set-up

Here we set-up the Administeration Teams (VISTA's fancy term for Medication Carts) and configure how Pick Lists will behave.

Set-up Administering Teams

Select Core Applications Option: UD  Unit Dose Medications

(Inpatient Medications - Version 5.0  04/16/99)

HI, HABIEL,SAM!  (PHARMACIST & PROVIDER)


          Align Labels (Unit Dose)
          Discontinue All of a Patient's Orders
   EUP    Edit Inpatient User Parameters
          Hold All of a Patient's Orders
   IOE    Inpatient Order Entry
   IPF    Inpatient Profile
          INQuiries Menu ...
          Label Print/Reprint
          Non-Verified/Pending Orders
          Order Entry
          PAtient Profile (Unit Dose)
          Reports Menu ...
          Supervisor's Menu ...

Select Unit Dose Medications Option: SUPERvisor's Menu


          Administering Teams
          Clinic Groups
          MANagement Reports Menu ...
          Non-Standard Schedule Report
          Non-Standard Schedule Search
          Order Set Enter/Edit
          PARameters Edit Menu ...
          PATient Order Purge
             **> Out of order:  TEMPORARILY UNAVAILABLE
          PIck List Menu ...
          Ward Groups

Select Supervisor's Menu Option: ADMINistering Teams

Select WARD: CHILD 2R 214-225 SOUTH    
  Are you adding 'Child 2R 214-225 South' as 
    a new MEDICATION ADMINISTERING TEAM (the 1ST)? No// Y  (Yes)
Select TEAM: CHILDREN
  Are you adding 'CHILDREN' as a new TEAM? No// Y  (Yes)
  Select ROOM-BED: 214-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '214-A-ICHS' as a new ROOM-BED (the 1ST for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 214-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '214-B-ICHS' as a new ROOM-BED (the 2ND for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 215-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '215-A-ICHS' as a new ROOM-BED (the 3RD for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 215-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '215-B-ICHS' as a new ROOM-BED (the 4TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 216-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '216-A-ICHS' as a new ROOM-BED (the 5TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 216-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '216-B-ICHS' as a new ROOM-BED (the 6TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 217-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '217-A-ICHS' as a new ROOM-BED (the 7TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 217-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '217-B-ICHS' as a new ROOM-BED (the 8TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 218-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '218-A-ICHS' as a new ROOM-BED (the 9TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 218-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '218-B-ICHS' as a new ROOM-BED (the 10TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 219-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '219-A-ICHS' as a new ROOM-BED (the 11TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 219-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '219-B-ICHS' as a new ROOM-BED (the 12TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 220-1 ??
  Select ROOM-BED: 220-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '220-A-ICHS' as a new ROOM-BED (the 13TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 220-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '220-B-ICHS' as a new ROOM-BED (the 14TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 221-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '221-A-ICHS' as a new ROOM-BED (the 15TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 221-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '221-B-ICHS' as a new ROOM-BED (the 16TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 222-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '222-A-ICHS' as a new ROOM-BED (the 17TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 222-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '222-B-ICHS' as a new ROOM-BED (the 18TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 223-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '223-A-ICHS' as a new ROOM-BED (the 19TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 223-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '223-B-ICHS' as a new ROOM-BED (the 20TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 224-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '224-A-ICHS' as a new ROOM-BED (the 21ST for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 224-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '224-B-ICHS' as a new ROOM-BED (the 22ND for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 225-A-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '225-A-ICHS' as a new ROOM-BED (the 23RD for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 225-B-ICHS    
          WARD(S):     ICHS Beds
                       Child 2R 214-225 South
  Are you adding '225-B-ICHS' as a new ROOM-BED (the 24TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: ?
 Answer with ROOM-BED
 Do you want the entire 24-Entry ROOM-BED List? Y  (Yes)
   Choose from:
   214-A-ICHS   
   214-B-ICHS   
   215-A-ICHS   
   215-B-ICHS   
   216-A-ICHS   
   216-B-ICHS   
   217-A-ICHS   
   217-B-ICHS   
   218-A-ICHS   
   218-B-ICHS   
   219-A-ICHS   
   219-B-ICHS   
   220-A-ICHS   
   220-B-ICHS   
   221-A-ICHS   
   221-B-ICHS   
   222-A-ICHS   
   222-B-ICHS   
   223-A-ICHS   
   223-B-ICHS   
                                   to exit: 
   224-A-ICHS   
   224-B-ICHS   
   225-A-ICHS   
   225-B-ICHS   
         
     You may enter a new ROOM-BED, if you wish

THE ROOM-BED CHOSEN MUST ALREADY BE DEFINED IN THE ROOM-BED FILE.
 Answer with ROOM-BED NAME, or WARD(S) WHICH CAN ASSIGN
 Do you want the entire ROOM-BED List? N  (No)
  Select ROOM-BED: 
Select TEAM: ?
    Answer with TEAM:
   CHILDREN   
         
     You may enter a new TEAM, if you wish
     Answer must be 3-15 characters in length.

ENTER THE NAME OF A TEAM THAT ADMINISTERS MEDICATION ON THIS  WARD.
Select TEAM: 

Select WARD: ADOLESCENT 2L 201-213 SOUTH    
  Are you adding 'Adolescent 2L 201-213 South' as 
    a new MEDICATION ADMINISTERING TEAM (the 2ND)? No// Y  (Yes)
Select TEAM: ADOLESCENT
  Are you adding 'ADOLESCENT' as a new TEAM? No// Y  (Yes)
  Select ROOM-BED: 201-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '201-A-ICHS' as a new ROOM-BED (the 1ST for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 201-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '201-B-ICHS' as a new ROOM-BED (the 2ND for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 202-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '202-A-ICHS' as a new ROOM-BED (the 3RD for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 202-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '202-B-ICHS' as a new ROOM-BED (the 4TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 203-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '203-A-ICHS' as a new ROOM-BED (the 5TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 203-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '203-B-ICHS' as a new ROOM-BED (the 6TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 204-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '204-A-ICHS' as a new ROOM-BED (the 7TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 204-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '204-B-ICHS' as a new ROOM-BED (the 8TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 205-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '205-A-ICHS' as a new ROOM-BED (the 9TH for this TEAM)? No// Y

  (Yes)
  Select ROOM-BED: 205-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '205-B-ICHS' as a new ROOM-BED (the 10TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 206-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '206-A-ICHS' as a new ROOM-BED (the 11TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 206-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '206-B-ICHS' as a new ROOM-BED (the 12TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 207-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '207-A-ICHS' as a new ROOM-BED (the 13TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 207-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '207-B-ICHS' as a new ROOM-BED (the 14TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 208-A-ICHS    
          WARD(S):     Adolescent 2L 201-213 South
  Are you adding '208-A-ICHS' as a new ROOM-BED (the 15TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 208-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '208-B-ICHS' as a new ROOM-BED (the 16TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 209-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '209-A-ICHS' as a new ROOM-BED (the 17TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 209-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '209-B-ICHS' as a new ROOM-BED (the 18TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 210-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '210-A-ICHS' as a new ROOM-BED (the 19TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 210-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '210-B-ICHS' as a new ROOM-BED (the 20TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 211-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '211-A-ICHS' as a new ROOM-BED (the 21ST for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 211-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '211-B-ICHS' as a new ROOM-BED (the 22ND for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 212-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '212-A-ICHS' as a new ROOM-BED (the 23RD for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 212-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '212-B-ICHS' as a new ROOM-BED (the 24TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 213-A-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '213-A-ICHS' as a new ROOM-BED (the 25TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 213-B-ICHS    
          WARD(S):     ICHS Beds
                       Adolescent 2L 201-213 South
  Are you adding '213-B-ICHS' as a new ROOM-BED (the 26TH for this TEAM)? No// 
Y  (Yes)
  Select ROOM-BED: 
Select TEAM:    ADOLESCENT
  TEAM: ADOLESCENT// 
  Select ROOM-BED: 213-B-ICHS// ??
    
   Choose from:
   201-A-ICHS   
   201-B-ICHS   
   202-A-ICHS   
   202-B-ICHS   
   203-A-ICHS   
   203-B-ICHS   
   204-A-ICHS   
   204-B-ICHS   
   205-A-ICHS   
   205-B-ICHS   
   206-A-ICHS   
   206-B-ICHS   
   207-A-ICHS   
   207-B-ICHS   
   208-A-ICHS   
   208-B-ICHS   
   209-A-ICHS   
   209-B-ICHS   
   210-A-ICHS   
                                   to exit: 
   210-B-ICHS   
   211-A-ICHS   
   211-B-ICHS   
   212-A-ICHS   
   212-B-ICHS   
   213-A-ICHS   
   213-B-ICHS   
         
     You may enter a new ROOM-BED, if you wish

THE ROOM-BED CHOSEN MUST ALREADY BE DEFINED IN THE ROOM-BED FILE.     The ROOM-B
ED selected will be listed under the above TEAM and WARD in
        PICK LISTS and MAR'S.
   
  Select ROOM-BED: 213-B-ICHS// 
Select TEAM: ?
    Answer with TEAM:
   ADOLESCENT   
         
     You may enter a new TEAM, if you wish
     Answer must be 3-15 characters in length.

ENTER THE NAME OF A TEAM THAT ADMINISTERS MEDICATION ON THIS  WARD.

Set-up Ward Groups

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Entering DEA Numbers

The DEA is a fact of life in the US and is baked into the pharmacy software. Even if you use VISTA outside of the US, you need to set-up DEA#'s/VA#'s in order to be able to order controlled substances. There are two steps: entering an institutional DEA number; then entering each Provider's DEA or VA #.

Enter Institutional DEA #'s

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Enter Providers' DEA #'s or VA #'s

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Entering and Configuring Pharmacy Users

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Patient Medication Information Sheets Set-up

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Order Set Creation

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Drug File Advanced Set-up

Auto Stop Dates for specific drugs

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Dose limits for specific drugs

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